Fill and Sign the Revised 1515 Form

BARBARA K. CEGAVSKE  Secretary of State  202 North Carson Street Carson City, Nevada 89701­4201 (775) 684­5708  Website:  www.nvsos.gov  Name Reservation Request  USE BLACK INK ONLY ­ DO NOT HIGHLIGHT  ABOVE SPACE IS FOR OFFICE USE ONLY  , hereby request that the name I,  be reserved for the period of 90 days.  Holder of Reservation:  Name  Address  City  State  Zip Code  Confirmation of Reservation:  (choose only one)  Mail to holder of reservation at the above address.  Email to the following address:  See other instructions below:  Notes:  FILING FEE: $25.00  Nevada Secretary of State Name Reservation This form must be accompanied by appropriate fees.  Revised:  1­5­15  *200104* *200104* BARBARA K. CEGAVSKE  Secretary of State  202 North Carson Street Carson City, Nevada 89701­4201 (775) 684­5708 Customer Order Instructions  Website:  www.nvsos.gov  SUBMIT THIS COMPLETED FORM  WITH YOUR FILING  USE BLACK INK ONLY ­ DO NOT HIGHLIGHT  Processing  24­Hour Expedite  (additional fee included) Regular Service Requested:  Date:  Phone:  Name of Entity:  Contact Name:  Return to:  Return Delivery:  (email or fax options do not receive a copy via mail; must be ordered separately)  Hold for Pick Up  Mail to Address Above  Fax to: Email to:  Other:  (explain below)  FedEx: Acct #  Order Description:  (include items being ordered and fee breakdown) *  Total Amount: *PLEASE NOTE: this office keeps the original paperwork.  The first file  stamped copy ordered at the time of filing is at no charge.  Each additional  copy is  $2.00 per page (plus  $30.00 for each certification).  Method of Payment:  Check/Money Order  Credit Card  (attach ePayment checklist)  Trust Account:  Use balance remaining in job #  Nevada Secretary of State Customer Order Instructions  Revised:  1­5­15  *230305* *230305* BARBARA K. CEGAVSKE  Secretary of State  202 North Carson Street 1 or 2­Hour Expedite Carson City, Nevada 89701­4201 (775) 684­5708  Customer Order Instructions Website:  www.nvsos.gov  SUBMIT THIS COMPLETED FORM  WITH YOUR FILING  USE BLACK INK ONLY ­ DO NOT HIGHLIGHT  Processing  1­Hour Expedite 2­Hour Expedite  (additional  $1000.00 fee included) (additional  $500.00 fee included) Service Requested:  Date:  Phone:  Name of Entity:  Contact Name:  Return to:  Return Delivery:  Hold for Pick Up  Mail to Address Above  Fax to: Email to:  Other:  (explain below)  FedEx: Acct #  Order Description:  (include items being ordered and fee breakdown) *  Total Amount: *PLEASE NOTE: this office keeps the original paperwork.  The first file  stamped copy ordered at the time of filing is at no charge.  Each additional  copy is  $2.00 per page (plus  $30.00 for each certification).  Method of Payment:  Check/Money Order  Credit Card  (attach ePayment checklist)  Trust Account:  Use balance remaining in job #  Nevada Secretary of State 1­2 Hr Customer Order Instructions  Revised:  1­5­15  *230405* *230405* Nevada Secretary of State Expedite Guidelines Revised: 1-5-15 IMPORTANT: To ensure expedited service, please mark “Ex pedite” in a conspicuous place at the top of the service request. Please indicate method of delivery. 24 -HOUR EXPEDITE SERVICE The Secretary of State offers a 24-hour expedite service on most filings processed by this office. If you choose to utilize t his service, please enclose with your filing the additional expedite fee. Please note t hat this expedite fee is in addition to the standard fee charged on each filing and/or order. Check the 24 -hour expedite box on your customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 24 -hour expedited service, include your telephone number and return information. Attach the order form or cover sheet to the top of your filing and submit to this office. Each filing will be returned by U.S.P.S. regular mail unless other arrangements are made. This office does not fax confirmation of a 24 -hour expedite. The fee for 24 -hour handling ranges from $25.00 to $125.00. Please consult our fee schedules for the appropriate 24 - hour expedite fee. If you require assistance, please contact this office. Time Constraints: Each filing submitted receives same day filing date and may be picked up within 24 -hours. Filings to be mailed the next business day if received by 2:00 pm of receipt date and no later than the 2nd busi ness day if received after 2:00 pm. Expedite period begins when filing or service request is received in this of fice in fileable form. 2- HOUR EXPEDITE SERVICE The Secretary of State offers a 2-hour expedite service on most filings processed by this office. If you choose to utilize the 2 -hour expedite service, please enclose with your filing an additional $500.00 per filing and/or order. Please note that this expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and submit the 2-hour customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 2- hour expedited service and include your telephone number and return information. Attach the order for m or cover sheet to the top of your filing and submit to this office. Each filing will be returned by U.S.P.S. r egular mail unless other arrangements are made. 1- HOUR EXPEDITE SERVICE The Secretary of State offers a 1-hour expedite service on most filings processed by this office. If you choose to utilize the 1 -hour expedite service, please enclose with your filing an additional $1000.00 per filing and/or order. Please note that this expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and s ubmit the 1- hour customer order instruction form. If not using our order form, state clearly in your cover l etter that you are requesting 1- hour expedited service and include your telephone number and return information. Attach the order form or cov er sheet to the top of your filing and submit to this office. Each filing will be returned by U.S.P.S. r egular mail unless other arrangements are made. 1- Hour and 2 -Hour Tim e Constraints: Each filing submitted for either 1 -hour or 2 -hour expedite receives same day filing date and will be acknowledged by fax or e -mail within expedite service time. Failure to indicate method of acknowledgement (fax or e -mail) or to provide a correct fax number or e -mail address may prevent the Secretary of State from acknowledging the filing of such documents. Filings may be picked up within the expedite serv ice period. Filings to be mailed will be mailed out no later than the next business day following receipt. Expedi te period begins when filing or service request is received in this office in fileable form. The Secretary of State reserves the right to extend the expedite period in times of ex treme volume, staff shortages or equipment malfunction. These extensions are few and will rarely extend more than a few hours. 24-hour, 2 -hour and 1 -hour Expedite Service Guidelines BARBARA K. CEGAVSKE Secretary of State 202 North Carson Street Carson City, Nevada 89701 -4201 Phone: (775) 684 -5708 Website: www.nv sos.gov ePayment Checklist    (For Counter, Fax and Mail Requests) BARBARA K. CEGAVSKE  Secretary of State  202 North Carson Street Carson City, Nevada 89701­4201  (775) 684­5708 Website:  www.nvsos.gov USE BLACK INK ONLY ­ DO NOT HIGHLIGHT  Service Type:  Counter  Mail  Fax Order Processing Requested: (Expedite Processing Requires Additional Fees)  Regular Processing  24­HOUR  Expedite 2­HOUR Expedite 1­HOUR Expedite Payment by Card  (card holder name and billing address required below) Card Type:  VISA  MasterCard  Discover American Express  Customer Credit Card Number:  V CODE *  * 3­digit number found on the far right of the backside of VISA, MasterCard and Discover cards 4­digit number found on the front right side of American Express card. NOTICE:  For security and verification purposes, all credit card payments must include the 3 or 4­digit CVV2 code  (VCode) number located on the credit card.  Failure to include this code will result in the rejection of your filing or service  request.  Credit Card Expiration Date:  Month  Year  Amount to Charge Card:  USD $ Order Information  (required)  Entity Name/Order Reference:  Card Holder Information:  Name as it Appears on the Account  Billing Address  City, State, Zip  Telephone  Payment Authorization  I authorize the Secretary of State to bill an amount not to exceed the following to be charged to the above listed  account(s):  Not to Exceed Amount: USD $ Authorized Signature  Nevada Secretary of State ePayment Checklist Revised: 1­5­15  X  Ext *230105* *230105*